Anti-kickback Law can ‘Kick’ You Where it Hurts!

The anti-kickback law in healthcare has been around since 1972. Its main purpose is to protect patients and federal programs from fraud and abuse by stopping the influence of money on healthcare decisions. A broad set of rules, but straightforward in the fact that “anyone who knowingly and willfully receives or pays anything of value to influence” healthcare decisions can be held accountable to a felony. The Stark statute, which came about in 1995, is sometimes thought to be the same as the anti-kickback law; however, it actually has a completely different scope. Anti-kickback violations require intent, Stark does not. Anti-kickback violations can be punishable by criminal penalties; Stark violations are covered by civil money penalties.

Anti-kickback violations can come in many forms. The more flagrant violations come from just flat out giving money to influence healthcare decisions. Less so, but just as consequential, are the payment of salaries above fair market value for the services provided.

The point here is to make certain provider salaries reflect the appropriate value anytime there is a contract between healthcare organizations, or an employment contract between an organization and the provider. Do your homework, get good legal advice, and whatever you do, don’t let the Anti-kickback Law can ‘Kick’ You Where it Hurts!